Efficacy of spirulina along with different physiotherapeutic modalities in the management of oral submucous fibrosis

Abstract

Context: Oral submucous fibrosis (OSMF) is an insidious, chronic, disabling disease that mainly affects the oral mucosa. Spirulina is a freshwater microalga which is considered as superfood by the WHO. Due to its antioxidant, anti-inflammatory, and immunomodulating properties, spirulina has shown promising results in the management of OSMF. A wide range of treatment modalities have been tried ranging from medical, physical, or surgical interventions, but combinations of these have shown better results. Aims: The study aimed to evaluate the efficacy of spirulina along with different physiotherapeutic modalities in the management of OSMF. Setting and Design: The present comparative study was conducted in the Department of Oral medicine and radiology, College of Dental Sciences, Davangere, Karnataka, India. The block randomization technique was used in the present study to enroll patients into three different groups. Methods: The study consisted of 45 OSMF patients who were divided randomly into three groups. All patients were given spirulina 500 mg twice a day for 3 months. Group A patients were instructed to perform isometric mouth exercises for 20 min, twice daily. Group B patients and Group C patients perform exercises using threaded tapered screw and mouth stretching device (MSD), respectively, ten times bilaterally twice a day. Clinical parameters such as burning sensation, mouth opening, tongue protrusion, and cheek flexibility were assessed every 15 days. Statistical Analysis Used: Descriptive data that included mean, numbers, and percentages were calculated for each group and were used for analysis. For intra- and inter-group comparison, paired t- and unpaired t -test was used, respectively. For all the tests, P = 0.05 or less was considered for statistical significance. Results and Conclusion: All the groups have shown statistically significant improvement in burning sensation, mouth opening, tongue protrusion, and cheek flexibility ( P < 0.05). Group C patients have shown better results followed by Group B and Group A patients. In the present study, spirulina along with different physiotherapeutic modalities was well tolerated by the patients, and significant improvement was seen in the MSD group.

Antioxidant treatments in patients with oral submucous fibrosis: A systematic review

“…Spirulina strongly induces antioxidant enzyme activity, helps to prevent lipid peroxidation and DNA damage, and scavenges free radicals this antioxidant activity makes it a potential treatment for different diseases as chronic obstructive pulmonary disease, muscle damage, and cardiovascular diseases among others 45 . Different studies included in this review demonstrate that spirulina together with mouth exercises improves significantly all the parameters analyzed in this review 22 and it has even been shown, as mentioned above, that spirulina alone shows better results in mouth opening than aloe vera 30 . Although less common, this compound has also been shown to be effective in other oral pathologies such as oral lichen planus and periodontitis 46,47 …”

“…A total of 97 articles were obtained from the initial search process: All the studies measured the progression of the OSMF in terms of mouth opening, [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] 17 articles reported on burning sensation, [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] 16 articles discussed tongue protrusion [15][16][17][18]21,26,28,31,33 and 8 articles examined cheek flexibility. 16,18,[21][22]…”

“…All the studies measured the progression of the OSMF in terms of mouth opening, 15–33 17 articles reported on burning sensation, 16–33 16 articles discussed tongue protrusion 15–18,21,26,28,31,33 and 8 articles examined cheek flexibility 16,18,21–24,28,31 . Regarding the type of the study, 17 articles were prospective clinical trials, 15,16,18–25,27–33 1 was a parallel‐group randomized monocentric trial, 17 and 1 was a prospective, randomized, single‐blind study 26 . A total of 1721 patients were treated.…”

Management Strategies for Oral Submucous Fibrosis- An Update

“…Spirulina in combination with isometric exercises/threaded tapered screw/mouth stretching device [35] antioxidant, anti-inflammatory and immuno-modulation 3 months BID Oral…”